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GENERAL PERMIT <br />CITY OF ORONO <br />CITY PERMIT NO. 8393 <br />5-Date. <br />Owner. <br />Contractor____ <br />City License No.. <br />P.O.BOX 66 <br />CRYSTAL BAY, MINNESOTA 55323 <br />(612)473-7357 <br />On r~\ V. I ~\\ 6* ^ Address <br />_________________ Address_____________________________________ <br />State License No. <br />REMARKS AND SPECIAL CONDITIONS <br />PERMIT TYPE AND FEE; <br />Inside Plumbing (^fixtures —) <br />Water Meter (Size__) <br />Meter#_____________ <br />□ NEW □ ADDITION □ REPAIR <br />Remote #. <br />Municipal Water Connection <br />□copper □____ <br />Municipal Sewer Connection <br />□ PVC GCast Q. <br />MWee SAC Charge <br />On Site Septic System <br />Fee S Water Well Fee <br />Mechanical Equipment Fee <br />Moving /Lifting Buildings Fee <br />Land Alteration (Excavation, Fee <br />Grading, Filling, etc.) <br />Fire Fee <br />Ff.i* s; <br />Fee S <br />'fc=s M'lS <br />Sprinkler System (Fire) Fee <br />Other: Fee <br />After-the-fact Investigation FeeFee S <br />ACKNOWLEDGEMENT <br />The undenlBned hereby ecknowledses receipt of thii limited <br />permit, tncludlnt acceptence of all ipecial Infomiatlon, <br />teimi, conditions or reQ^ilrements written above. The <br />undersigned understands and ^'creei under penalty of law <br />that this permit Is strictly UmiUu Zz *^ope to the work, <br />activity or improvement specified; that iMs permit does <br />not grant any authority to do work or activl*<#s requirini <br />separate permit approvals: and that this permit aoes not <br />grant authority to violate any provision of any City <br />ordinance or State law, rule or regulation. All work shall be <br />done In strict compliance with all City ordinances, building <br />codes and/or health department regulations, and shall be <br />subject to Inspection, approval or rejection by the City. <br />Whenever so ordered, the undersigned agrees to correct <br />any work found to be In violation of the conditions of <br />this permit. <br />Signature of Applicant -— <br />TOTAL <br />State Surcharge: <br />Total Amount Paid to City <br />Fee S, <br />Fee S. <br />This permit is not valid until the proper fee is paid and <br />it is approved by an authorized City Offlcial. <br />Signature of City Official <br />Code: Whhe-File Copy Canaiy-Iiwpectot’sCopy Hnk-Ftaance Copy Gold-AppUcant’i Receipt